Aurora submissions
Permanent URI for this collection
This site is linked to Aurora
Browse
Recent Submissions
Item Restricted The Barriers and Enablers to the Use of Parenteral Methotrexate in Rheumatoid Arthritis Patients: A Scoping Review(Wiley, 2023) Tan, J.M.; Reeve, E.; Fraser, L.; Proudman, S.M.; Wiese, M.D.OBJECTIVES: Methotrexate (MTX) is effective in controlling disease activity in Rheumatoid Arthritis (RA). Parenteral MTX may have benefits over oral MTX, but it is rarely used in practice. To better understand this low usage rate, it is necessary to explore the barriers and enablers of therapy from the perspective of RA patients. The objectives of this scoping review were to describe RA patients' perspectives on the barriers and enablers to the use of parenteral MTX and to identify the research gaps in this field. METHODS: The search was performed in Medline, Embase, Scopus and Cochrane Library from inception to May 2021. Data synthesis was conducted using the Theoretical Framework of Acceptability. This scoping review included any type of study which explored the use of parenteral MTX by adult RA patients from the patients' perspective, written in English. RESULTS: Fifteen studies were included; findings related to the constructs "affective attitude", "burden", "intervention coherence" and "self-efficacy" were explored the most, while some were rarely ("opportunity cost" and "perceived effectiveness") or not ("ethicality") reported. RA patients were generally satisfied with MTX injections ("affective attitude"). From the "burden" construct, the requirement for dexterity for administering MTX by injection was considered a barrier, whereas the lack of significant pain from MTX injection was considered an enabler. CONCLUSIONS: The findings suggested that patients generally preferred parenteral MTX formulations with attributes that facilitate self-administration. However, much of the identified research focused on prefilled pen devices, and significant gaps were identified, such as a lack of qualitative research. This article is protected by copyright. All rights reserved.Item Metadata only Development of the Double-Blind, Randomized Trials of Effects of Antihypertensive Medicines (DREAM) Database and Characteristics of the Included Trials: Protocol for an Umbrella Review and Meta-Analyses(JMIR Publications, 2025) Salam, A.; Dhurjati, R.; Vidyasagar, K.; Kaistha, P.; Esam, H.; Haghdoost, F.; Pant, R.; Kumar, A.; Kanukula, R.; Thode, R.; Baddam, R.; Chaudhri, K.; Wang, N.; Bhaumik, S.; Gnanenthiran, S.R.; Tiruttani, S.K.; Rodgers, A.Background: A comprehensive evaluation of short-term effects of antihypertensive medicines is important for informing guidelines and clinical practice. Objective: We aimed to develop the Double-blind Randomized trials of Effects of Antihypertensive Medicines (DREAM) database to facilitate a series of meta-analyses evaluating the short-term effects of antihypertensive medicines. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Epistemonikos from inception until December 2022 to identify relevant randomized clinical trials (RCTs). We included RCTs in the DREAM database if they were double-blind, enrolled adult participants, evaluated the 5 major classes of antihypertensive medicines over a duration of 2 to 26 weeks, and were published in the English language. Screening of records for inclusion and data collection were both conducted in duplicate. The planned meta-analyses using the DREAM database will follow standard methods as recommended by the Cochrane Handbook for Systematic Reviews. The general methods for these meta-analyses are outlined. Results: The DREAM database includes 1623 RCTs (4359 comparisons), of which 44% (707/1623) were placebo-controlled, 70% (1141/1623) had parallel-group allocation, and 37% (607/1623) had 3 or more randomized groups. A total of 304,253 participants (mean age 54 years; 509/1623, 46% female) were included, 86% (1391/1623) of RCTs had participants with hypertension, and 11% (175/1623) of RCTs had participants with cardiovascular disease at baseline. RCTs with at least 1 group randomized to combination therapy accounted for 23%(371/1623). The median duration of treatment was 8 weeks. Most (93%, 1509/1623) RCTs reported data on effects on blood pressure. Conclusions: The first series of meta-analyses using the DREAM database will assess the effects of antihypertensive medicines on blood pressure and safety outcomes, including effects on headache, and cardiovascular events. The findings of these meta-analyses will inform clinical practice guidelines and help identify priorities for future research.Item Metadata only Key Mediators Reducing Socioeconomic Inequality in Early Childhood Caries(SAGE Publications, 2025) Dao, A.T.M.; Do, L.G.; Stormon, N.; Nguyen, H.V.; Ha, D.H.Objectives: Socioeconomic status (SES) has a significant effect on the burden of early childhood caries (ECC), yet addressing SES disparities remains challenging. This study aimed to identify and quantify the most impactful mediator linking SES effect to the occurrence of ECC using advanced causal mediation analysis, to inform targeted interventions that reduce SES-related disparities in ECC. Methods: Data were drawn from the Study of Mothers’ and Infants’ Life Events, a cohort of 2,182 mother–child dyads recruited from Adelaide’s 3 largest public hospitals (2013–2014). Baseline questionnaires captured family SES, while ECC clinical indicators were assessed at age 5 y. Three mediation pathways linking SES and ECC were examined including dietary intake represented by free sugar intake (FSI); oral hygiene practices, including toothbrushing habits and plaque presence; and dental visiting patterns. Mediation effects were quantified as natural indirect effects (NIE) using causal mediation analysis based on the counterfactual framework, with validation via 5-fold cross-validation to ensure robustness. Results: FSI was the only pathway with a significant mediation effect. Each 1-standard-deviation increase or decrease in SES was associated with a corresponding 6% reduction or increase in ECC risk at age 5 y through the mediating effect of FSI at age 2 y. The NIE of FSI accounted for 52% of SES’s total effect on ECC. In contrast, oral hygiene and dental visiting patterns showed no significant mediation effects. Conclusions: Reducing early childhood FSI could mitigate half of SES-related disparities in ECC. Targeted interventions focusing on FSI reduction hold promise for lowering ECC risk, with future research needed to evaluate their effectiveness. Knowledge Transfer Statement: Clinicians and policymakers should prioritize nutrition education and sugar reduction initiatives as key components of early prevention in pediatric dentistry, especially for low-SES populations. Incorporating FSI screening into routine visits enables medical and dental practitioners to educate caregivers on the impact of free sugars on dental health.Item Open Access Media Engagement: A Best Practice Guide for the Australian Seafood Industry(Fisheries Research and Development Corporation, 2020) Fielding, V.; Phillipov, M.; Farmery, A.; Gale, F.; Fisheries Research and Development CorporationThis guide includes best practice principles, strategies and practical advice that will enable the Australian seafood industry to plan, carry out, and evaluate communication activities. In today’s hyper-mediated world, effective media engagement is essential. Even if media engagement feels like just ‘one more thing’ on an ever-expanding list of tasks, this guide will help to make best use of the time and resources available to ensure the best return possible.Item Metadata only Exploring the impact of geometric variation on electromagnetic performance in a coaxial coil system(Current Science Association in collaboration with the Indian Academy of Sciences, 2025) Yang, Y.; Jafari, A.; Robertson, W.; Arjomandi, M.To optimise coil design for creating an efficient electro-magnetic system characterised by high precision, the present study investigates the impact of varying coil geometry on the electromagnetic force generated bet-ween a pair of coaxial cylindrical coils. The study utilises a multifaceted approach to identify the rela-tionships between axial magnetic force, air-gap dis-tance and coil radial thicknesses. Systematic changes in coil geometry are made to understand the sensitivity of electrical power consumption to the generation of magnetic force, and an analytical model is used to un-derstand the relationships. In this article, limitations on the conventional magnetic force computation meth-od established by previous researchers are identified. Additionally, the results indicate that using thicker coils significantly increases magnetic force production. This advantageous amplification is counterbalanced by increased coil resistance, inevitably leading to reduced efficiency of electromagnetic force production. A mathematical model is developed here for computing the coil efficiency, and methods are proposed to simul-taneously optimise the generation of magnetic force by coils while ensuring.Item Restricted Economic evaluation of subcutaneous ketamine injections for treatment resistant depression: A randomised, double-blind, active-controlled trial - The KADS study(Elsevier BV, 2025) Chatterton, M.L.; Perez, J.K.; Thai, T.; Faller, J.; Loo, C.K.; Glozier, N.; Barton, D.; Baune, B.T.; Mills, N.T.; Fitzgerald, P.B.; Glue, P.; Sarma, S.; Hadzi-Pavlovic, D.; Dong, V.; Martin, D.; Mitchell, P.B.; Berk, M.; Carter, G.; Hackett, M.; Hood, S.; et al.BACKGROUND: Ketamine is effective for treatment resistant depression (TRD); but cost-effectiveness evidence remains limited. AIMS: To evaluate the cost-effectiveness of subcutaneous ketamine for TRD from health sector and societal perspectives. METHODS: A cost-utility analysis alongside the KADS randomised controlled trial (RCT) involved 174 participants receiving ketamine or midazolam (active control) twice weekly for 4 weeks. Healthcare resource use, transportation, carer time and lost productivity data were collected via self-reported questionnaire at baseline, end of RCT (week 4) and RCT 4-week follow-up (week 8). Quality-adjusted life years (QALYs) were calculated using AQoL-8D utility values. Initial dosing was fixed (cohort 1) and changed to response-guided dosing (cohort 2). Base-case 1 included control arm treatment costs; base-case 2 excluded these costs. RESULTS: At end of RCT, cohort 2 utility values were significantly higher for ketamine than the control treatment (0.435 vs. 0.352; p < 0.05). Health sector incremental cost-effectiveness ratios (ICERs) in base-case 1 indicated ketamine was dominant (less costly, more effective) with probabilities of falling below $50,000/QALY of 89 % (end of RCT) and 91 % (total across 8-weeks). Societal perspective probabilities were lower (30-32 %). In base-case 2, ketamine was not cost-effective (ICERs: $251,250/QALY at end of RCT; $108,500/QALY across 8-weeks), with minimal probabilities (0-5 %) of falling below $50,000/QALY. CONCLUSIONS: The initial four-week ketamine treatment phase appeared cost-effective from a health sector perspective when including control arm costs, although societal perspective results were less favourable. Excluding control treatment costs highlighted substantial uncertainty, emphasising the importance of selecting an appropriate comparator for an economic evaluation.